Please contact your Health Visitor or the Infant Feeding team before starting bottle feeding or as soon as possible afterwards to we can support you to feed your baby safely and responsively. 

If you are planning to bottle feed with expressed breast milk or infant formula, these tips will help keep your baby safe and healthy.

Building a happy baby: A Guide for Parents Leaflet - Baby Friendly Initiative (unicef.org.uk)

KEY FACT: First infant formula is the only type of formula your baby needs until they are one year old. When your baby is one year old, they can start to drink whole cows' milk.

Take a look at Unicef's Baby Friendly video - Importance of relationship building:

You will need a number of bottles and teats, as well as sterilising equipment. There’s no evidence that one type of teat or bottle is better than any other. But some feeding bottles have shapes or patterns that make them difficult to clean thoroughly. As hygiene is so important, simple bottles that are easy to wash and sterilise are probably best.

KEY FACT: There remains insufficient evidence that automatic preparation machines are safe in the preparation of powdered infant formula, and it is recommended that families and carers use boiled water cooled no longer than 30 minutes to >70°C to make up powdered infant formula, as recommended.

Take a look at the Start 4 Life Guide to bottle feeding. Make sure your bottles and teats are ALWAYS sterilised. If you’re using infant formula, pay close attention to the instructions on the packet when you make up the feed.

KEY FACT: To reduce the risk of infection to your baby, make up each infant formula feed ONLY as your baby needs it, using boiled water at a temperature of 70°C or above. Start 4 Life's step-by-step guide shows you how to do this. Water at this temperature will kill any harmful bacteria that may be present. Remember to let the feed cool before you give it to your baby.

Bottle feeding as responsively as possible can help support the development of a close and loving parent-infant relationship. Every feed is an opportunity to get to know your baby. Try to do as many of the feeds yourself as you can and limit the amount of people who give baby feeds.

  1. Feed your baby when they show signs of being hungry: look out for cues (moving head and mouth around, sucking on fingers). Crying is the last sign of wanting to feed, so try and feed your baby before they cry (for more details, see the Start4Life Guide to bottle feeding).
  2. Hold baby close in a semi-upright position so you can see their face and reassure them by looking into their eyes and talking to them during the feed. Try and alternate the side you hold baby.
  3. Begin by inviting baby to open their mouth: softly rub the teat against their top lip. Gently insert the teat into baby’s mouth, keeping the bottle in a horizontal position (just slightly tipped) to prevent milk from flowing too fast.
  4. Watch your baby and follow the cues for when they need a break; these signs will be different from one baby to the next, they may splay their fingers and toes, spill milk out of their mouth, stop sucking, turn their head away or push the bottle away. Gently remove the teat or bring the bottle downwards to cut off the flow of milk.
  5. Your baby will know how much milk they need. Forcing your baby to finish a feed will be distressing, and can mean your baby is overfed.

KEY FACT: ALWAYS THROW AWAY any unused formula or breast milk after you have finished feeding your baby.

Download Unicef's leaflet - Infant formula and responsive bottle feeding - Baby Friendly Initiative

Go with the flow

Babies differ in how often they want to feed and how much milk they want to take. Feed your baby when they’re hungry, and don’t try to force them to finish a bottle.

KEY FACT: Never leave a baby alone to feed with a propped-up bottle as they may choke on the milk.

Babies differ in how often they want to feed and how much milk they want to take. Feed your baby when they’re hungry, and don’t try to force them to finish a bottle.

KEY FACT: Never leave a baby alone to feed with a propped-up bottle as they may choke on the milk.

Some babies bring up more milk than others during or just after a feed. This is sometimes called possetting, regurgitation or reflux. Keep a muslin square handy just in case. It can be upsetting when this happens, and you may be worried that something is wrong. If it happens often, or your baby is violently sick, appears to be in pain or you’re worried for any other reason, talk to your health visitor or GP.

Check that the hole in your baby’s teat is not too big – giving milk too quickly can cause sickness. Sitting your baby upright on your lap after a feed may help.

If your baby brings up a lot of milk, they may be hungry again quite quickly. Don’t force them to take more milk than they want during a feed. Every baby is different. Some prefer to feed little and often.

When using infant formula, always use the recommended amount of infant formula powder stated on the packet. Don’t add extra infant formula because using too much can make your baby constipated and may cause dehydration.

If your baby is under eight weeks old and hasn’t passed a stool (had a poo) for two to three days, discuss this with your Health Visitor or GP, particularly if your baby is gaining weight slowly. Your baby should be gaining weight and have wet and dirty nappies.

For the first six months you should feed your baby only breast milk or first infant formula. First infant formula made from cows’ or goats’ milk is the only suitable alternative to breast milk in the first 12 months of your baby’s life. Only use soya-based infant formula if your GP has advised you to. 

Second infant formula, follow-on formula or growing-up milks are absolutely NOT NEEDED at any time. Your baby’s food diet will provide all the nutrients baby needs. Research shows breastmilk continues to provide other benefits until 2 years and beyond, such as immune help and growth hormones, and you may continue to breastfeed once your baby is eating solids as long as you and your baby wish. The World Health Organisation and Unicef recommends breastfeeding for 2 years and beyond. 

You may mix breastmilk or infant formula (prepared milk not just the powder) or whole cows milk in your child's meals from 6 months onwards.

Whole cows’ milk can be given as a drink from one year. Semi-skimmed milk can be introduced once your child is two years old, as long as they’re a good eater and they have a varied diet. Skimmed and 1% milk aren’t suitable for children under five, as they don’t contain enough calories. Goats’ and sheep’s milk are not suitable as a drink for babies under one year.

You can give your child unsweetened calcium-fortified milk alternatives, such as soya, almond and oat drinks, as part of a healthy, balanced diet from the age of one. Children under the age of five should not be given rice drinks because of the levels of arsenic they contain.

If your child has an allergy or intolerance to milk, talk to your health visitor or GP. They can advise you on suitable milk alternatives.

When using infant formula, always use the recommended amount of infant formula powder stated on the packet. Don’t add extra infant formula because using too much can make your baby constipated and may cause dehydration.

If your baby is under eight weeks old and hasn’t passed a stool (had a poo) for two to three days, discuss this with your Health Visitor or GP, particularly if your baby is gaining weight slowly. Your baby should be gaining weight and have wet and dirty nappies.

Read more about cows’ milk allergy and lactose intolerance on NHS.UK

If you have any concerns or questions please speak to your Health Visitor, GP or the Infant Feeding team. We’d be happy to help support you and your baby.  You’ll find the phone number for your Health Visitor in your baby’s red book. 

Why does my baby sometimes vomit after a feed?

Some babies bring up more milk than others during or just after a feed. This is sometimes called possetting, regurgitation or reflux. Keep a muslin square handy just in case. It can be upsetting when this happens, and you may be worried that something is wrong. If it happens often, or your baby is violently sick, appears to be in pain or you’re worried for any other reason, talk to your health visitor or GP.

Check that the hole in your baby’s teat is not too big – giving milk too quickly can cause sickness. Sitting your baby upright on your lap after a feed may help.

If your baby brings up a lot of milk, they may be hungry again quite quickly. Don’t force them to take more milk than they want during a feed. Every baby is different. Some prefer to feed little and often.

Could formula feeding make my baby constipated?

When using infant formula, always use the recommended amount of infant formula powder stated on the packet. Don’t add extra infant formula because using too much can make your baby constipated and may cause dehydration.

If your baby is under eight weeks old and hasn’t passed a stool (had a poo) for two to three days, discuss this with your Health Visitor or GP, particularly if your baby is gaining weight slowly. Your baby should be gaining weight and have wet and dirty nappies.